Saudi Cultural Missions Theses & Dissertations
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Item Restricted The Impact of Human Resource Flexibility on Organizational Agility: The Moderating Role of Percieved Organizational Support in the Private Healthcare Sector of Hafr Al-Batin(Saudi Digital Library, 2025) ALSHAMMARI, KHALIFAH ZIYAD S; Albdareen, Rokaya Qaseemهدفت هذه الدراسة إلى الكشف عن أثر مرونة الموارد البشرية في الرشاقة التنظيمية، مع التركيز على الدور المعدل للدعم التنظيمي المدرك في القطاع الصحي الخاص في محافظة حفر الباطن. استخدمت الدراسة المنهج الوصفي التحليلي، حيث تم توزيع استبانة على مجتمع الدراسة الذي تكون من (500) موظفا وموظفة من العاملين في عدد من المستشفيات الخاصة(مستشفى نور خان، ومستشفى المعالي) العاملة في حفر الباطن. أظهرت نتائج التحليل الإحصائي أن مرونة الموارد البشرية بأنواعها (الوظيفية، السلوكية، ومرونة الممارسة) تؤثر بشكل إيجابي ومباشر على الرشاقة التنظيمية، كما تبين أنه لم يكن للدعم التنظيمي المدرك دور في تعزيز هذا الأثر. وقد أوصت الدراسة بضرورة تعزيز ممارسات مرونة الموارد البشرية وزيادة الدعم التنظيمي لتحقيق مستويات أعلى من الرشاقة في بيئة العمل، خصوصاً في ظل التغيرات المتسارعة التي يشهدها القطاع الصحي.15 0Item Restricted Effective Supervision on Road Maintenance Projects in KSA Based on Performance Indicators(Saudi Digital Library, 2025) ALSHRARI, SULTAN SALEM ATIQ; ALSHRARI, SULTANThis study aimed to examine the effectiveness of road maintenance project supervision in Saudi Arabia based on performance indicators. A descriptive-analytical approach was adopted, using questionnaires and surveys alongside official project documents to ensure the reliability and accuracy of the collected data. The study sample included supervisors, technicians, and officials from government agencies and specialized companies. Using stratified random sampling, 250 questionnaires were distributed, and 211 valid responses were obtained, representing a response rate of 84.4%. All participants had at least two years of practical experience and participated voluntarily. Descriptive analyses indicated a high level of importance across all dimensions of effective supervision. Performance-based supervision using Key Performance Indicators (KPIs) scored an average of 3.98, while the average overall implementation results were 3.93, and the average road maintenance KPI was 3.91. These results reflect a strong consensus among participants regarding the crucial role of performance-based supervision in achieving effective project outcomes. The study recommends standardizing key performance indicators, implementing real-time monitoring systems, enhancing supervisory efficiencies, ensuring contractor accountability, promoting transparency, and encouraging innovation to improve the effectiveness of road maintenance project supervision.14 0Item Restricted The Special Economic Zones: An Investigation of Why We Might Invest in The Special Economic Zones in Saudi Arabia? Vision, Prediction, And Direction(Saudi Digital Library, 2025) Almansour, Hanan; Bu, QingxiuAbstract Investment in SEZs is essential for a country to develop and succeed. This dissertation investigates the potential impact associated with an investment in special economic zones in Saudi Arabia and the possible effects of such assets on the local and regional economy. The legal framework within which the SEZs operate is explored, and the future vision, predictions, and direction of the SEZs in Saudi Arabia are discussed in light of the Saudi Vision 2030. The methodology employed in this dissertation includes a qualitative approach whereby a literature review and an analysis of relevant Saudi Arabian laws and regulations are conducted. The literature review draws on research from Saudi Arabia, the Gulf region, and the international arena. It examines the various aspects of SEZs, including their legal framework, benefits and economic impacts. The analysis of relevant laws and regulations examines Saudi Arabian statutes and rules governing SEZs and how these laws affect the benefits associated with an investment in SEZs. In addition, the findings of this dissertation also suggest that SEZs can positively impact the local and regional economy, as they provide a way for businesses to access new markets and generate economic growth. They can also play an essential role in job creation and poverty alleviation. On the other hand, SEZs in Saudi Arabia is governed by a comprehensive legal framework that provides numerous benefits associated with an investment in SEZs. Furthermore, some benefits of investing in SEZs include preferential tax treatment, greater access to international markets, and streamlined bureaucratic procedures. On the other hand, the conclusion of this dissertation suggests that SEZs in Saudi Arabia will continue to be a viable investment option for investors and businesses looking to access new markets.8 0Item Restricted Identity Construction Among Higher Education Saudi Students in The UK(Saudi Digital Library, 2025) Althubiti, Rayed; Sheikh, Mustapha; Alonso, GregorioThe steady rise in Saudi students attending British universities gives them a unique experience since it exposes them to a new way of life with distinct beliefs, values, and customs. However, they might also have to cope with the contemporary anti-Muslim sentiment known as Islamophobia. This study aims to better understand how Saudi students create and re-create their identities through their experiences while studying in the UK. In particular, the following inquiries are addressed: 1) Which academic and everyday life experiences do Saudi students share during their time studying in the UK? 2) What do their combined experiences reveal about their identity as Saudis? Twenty Saudi students enrolled in UK higher education institutions participated in in-depth semi-structured interviews as part of a narrative approach used to answer these questions. The approach of interviewing them twice provides an even deeper understanding of their stories and how time affected their attitudes during two periods: before coming to the UK and after spending a while in the UK. With respect to the first query, the results of this study show that Saudi students have a lot of interests in common while they are studying in the UK. These narratives examine how Saudi students viewed British identity before coming to the UK and how their views on race changed over time. The findings also shed light on their accounts of encounters with Islamophobia, discrimination, and equality in their social and academic lives. The accounts also reveal how Saudi students socialise with people of the opposite gender in the UK and how they engage with locals, Muslims, and other Saudis. The stories explore how the students perceive gender roles in Saudi Arabia and the United Kingdom. The narratives also look at how Saudi students' views of British identity have changed as a result of their time in the UK. Regarding the second query, the research's conclusions show how Saudi students create their gender identities. Most participants in this study acknowledged that their gender identities and responsibilities had changed since coming to the UK, showing that they had adjusted to these changes. Furthermore, this study also emphasizes the shift in the religious identities of Saudi students. The experiences of Saudi students studying in the UK reveal a change, leading to greater sense of solidarity with other Muslims and a more steadfast dedication to their Islamic faith.9 0Item Restricted Understanding Saudi Female Students’ and Teachers’ Perceptions of Physical Education Provision in the Kingdom of Saudi Arabia in Light of Vision 2030 Reforms(Saudi Digital Library, 2025) Nahari, Laila; Makopoulou, KyriakiBackground The Kingdom of Saudi Arabia (KSA) introduced physical education (PE) to girls’ public state schools in 2017 as part of Saudi Vision 2030 (SV30), a national reform aiming to promote health, empowerment, and gender equity. While the reform is historic, girls’ voices and teachers’ experiences remain under-researched. despite cultural, structural, and policy challenges such as limited facilities, specialist staff shortages, and mixed social support. Aim The aim of the present study was to investigate the perceptions and experiences of female students and female PE teachers in KSA regarding the implementation of PE in the unique historical context of the country. Design and Methodology A mixed-methods multiple-case study design was used, informed by social constructivism. The study was carried out in three state secondary schools in one Saudi city. Study 1: A cross-sectional anonymous online questionnaire (n = 60 girls, Grades 7–9) explored female students’ enjoyment, perceived purpose, and preferred ways of learning in PE. Study 2: A multi-site qualitative case study (7 focus groups, n = 30 girls) examined girls’ lived experiences, and perceived challenges, using task-based participatory activities. Study 3: An exploratory sequential mixed-methods study investigated female PE teachers’ perceptions, practices, confidence, and challenges through semi-structured interviews (n = 5) followed by a quantitative survey (n = 16). Key Findings Across the three studies, several patterns converged. Both girls and teachers recognised PE as important for health, fitness, and stress relief, though a minority questioned its academic relevance. Students strongly preferred practical, hands-on activities such as football, basketball, and self-defence, and teachers agreed these lessons generated more engagement. However, many lessons remained theory-heavy due to limited space, equipment, and teacher confidence. Teachers emerged as pivotal change agents. Their support was strongly linked to girls’ enjoyment and positive health perceptions, while their identities and beliefs shaped whether they became innovators or reluctant implementers. Finally, facilities and resources were consistently highlighted as inadequate, with students and teachers calling for safe, well-equipped spaces. At the same time, several divergences emerged in how girls perceived the value of PE. While most emphasised the importance of developing physical competence, others viewed PE as a pathway to well-being, fitness, and a positive body image. Some also framed PE in terms of empowerment and gender equality, reflecting broader views shaped by SV30 expectations. Teachers’ responses similarly varied, some advocated competitive, performance-oriented models, whereas others promoted more inclusive and empowering approaches. Many teachers also noted a gap between their theoretical knowledge and practical confidence, underscoring the need for sustained and targeted professional development. Discussion The findings show that girls’ PE in KSA is more than a new subject. It is a space where health, identity, and social change intersect. Girls described PE as empowering: they understood health, felt able to manage their experience, and found personal meaning in movement, reflecting Antonovsky’s salutogenic model of comprehensibility, manageability, and meaningfulness. Yet some girls adopted narrow, body-image views of health, echoing Kirk and Quennerstedt’s critique of biomedical discourses. Constructivist, student- centred lessons helped many girls to experience freedom, strength, and equity, supporting arguments by Oliver, Kirk, and Stolz that transformative learning in PE can reshape relationships with the body. Teachers emerged as key change agents. Confident teachers reframed PE to support cultural change and created supportive learning environments, aligning with Rogers’ concept of the teacher as a change agent and Giroux’s view of teachers as cultural workers. Where teachers lacked confidence or felt identity conflicts, resistance slowed reform, illustrating Tschannen-Moran’s work on self-efficacy and Kelchtermans’ ideas on professional values. A persistent policy–practice gap was evident. Despite strong SV30 policies, limited training and resources left many lessons theory-heavy and repetitive, consistent with Fullan’s implementation gap and Kirk & Tinning’s critique of policy collapse at classroom level. Gendered assumptions about “appropriate” activities reproduced inequalities, echoing Amade-Escot and Penney & Evans. Finally, the research highlights the need for diversity, inclusion, and student voice. Girls wanted choice, feedback, and dialogue with teachers’ evidence that students should be partners in curriculum design, not just recipients, as argued by Fielding and Enright & O’Sullivan. Intersectional factors of religion, gender, and culture shaped experiences, underscoring the importance of culturally responsive and participatory approaches to sustain reform. Conclusion This thesis provides the first localized, evidence-based account of girls’ PE in Saudi Arabia. It demonstrates that successful reform requires more than policy: it depends on culturally relevant pedagogy, empowered teachers, and ongoing investment in resources and training. The study contributes to global debates on gender, inclusion, and quality physical education in non-Western contexts.19 0Item Embargo Organisational Readiness for AI in the Front-end Planning of Public Construction Projects(Saudi Digital Library, 2025) Felemban, Haneen Mohammedhassan; Khan, M SohailThe Kingdom of Saudi Arabia (KSA) Vision 2030 initiatives aim to diversify the economy and enhance the public sector. This led to an increase in public projects. However, many projects suffer from underperformance and failure, with these issues frequently arising during Front-end Planning (FEP), which is a crucial initial phase of project definition. Artificial Intelligence (AI) has been identified as having the potential to lower the barrier of carrying out FEP and improve decision- making for better overall project outcomes. The adoption of AI at the FEP stage can significantly improve practices, however, the readiness of public construction organisations to adopt AI remains under-explored. This research established foundational knowledge (exploratory) and test hypotheses (explanatory), defined as collective capability, culture, and governance structure required for AI integration in KSA public construction. The research employed a sequential exploratory mixed-methods approach grounded in the Technology-Organisation-Environment (TOE) Framework and Theory of Planned Behaviour (TPB). The research first conducted 30 semi-structured interviews with key stakeholders (government officials, engineers, and industry experts) to explore their perspectives on FEP and enablers and barriers to adopt AI, while an online survey of 234 professionals validated these insights. Purposive and snowball sampling ensured relevance, while the demographic profile reflected the structure of the Saudi construction workforce, enhancing the representativeness of the sample. Findings revealed a robust model (R²=0.995, p<.001) where organisational absorptive capacity (β =0.261) and organisational maturity (β= 0.235) emerged as key factors for this readiness. Followed by technological readiness (β= 0.216), environmental support (β= 0.143), and senior management support (β= 0.126). reinforced by government support, senior management engagement, and technological readiness. Survey results showed 82.9% identified team competence as the most critical failure factor at FEP. These insights extended the theory by integrating TOE with TPB, showing that structural enablers such as process and resources, must align with behavioural dimensions to achieve readiness. Overall, this research makes a novel theoretical contribution by demonstrating how the intersection of mixed-methods, context specific (KSA), multi-level frameworks (TOE+TPB), specific project phases (FEP), and industry specificity (construction) creates unique adoption dynamics absent from Western- centric models. This research contributes to knowledge by identifying the interconnected role of organisational absorptive capacity and organisational maturity in determining organisational readiness to adopt AI. Theoretically, it extends the TOE framework by integrating individual-level behavioural factors, offering a contextualised perspective and provides the first empirical examination of AI adoption in FEP in the KSA construction industry. This framework provides a contextualised approach to AI adoption tailored to the KSA public construction sector, highlighting the need to reduce bureaucratic rigidity, enhance managerial communication, and promote learning in organisational culture. It also addresses employee concerns related to job security to ensure readiness for successful AI adoption. Future research should explore the integration of dynamic capabilities theory to address aspects of readiness development, which can guide policymakers and industry practitioners in improving organisational readiness for AI.24 0Item Restricted Governance and Development of SMEs in the Kingdom of Saudi Arabia: Public Policy and the Role of Multiple Government Actors(The University of Manchester, 2025) Alfageer, Mansoor; Hossain, FarhadSmall and Medium-sized Enterprises (SMEs) are key drivers of economic growth, job creation, and social development. In the Kingdom of Saudi Arabia, SMEs account for 99% of all businesses, yet their contribution remains modest relative to international benchmarks and face persistent growth obstacles. This research aims to explore how public policy, public governance and regulatory frameworks, implemented by multiple government actors (MGAs), affect the development, contribution and sustainability of SMEs in Saudi Arabia. It has three main objectives: to explore the factors that influence SME growth, development and contribution; to explore how government policies shape SME resilience and market adaptation amid economic, social and institutional transformations; and to assess the role of MGAs in addressing SME development challenges and identifying governance gaps in greater depth for improvement. Adopting a multidisciplinary public policy and management approach, the study draws on theoretical governance perspectives and SME development concepts to explain how policy design, implementation and coordination among MGAs shape SME outcomes in Saudi Arabia. A qualitative case study approach was adopted. Data were collected in Riyadh through semi-structured interviews with 45 participants recruited via snowball sampling. Participants included senior government officials as key informants, SME owners, and business executives and professionals, who shared their perceptions of public policy and SME development, particularly after the launch of national transformation in 2016. Data were coded and thematically analysed in alignment with the research questions. Findings reveal that the national transformation since the launch of Vision 2030 has reshaped the macro-environment affecting SMEs. Requirements to nationalise employment, comply with a rapidly evolving regulatory framework, and meet taxation and a variety of fees collected by MGAs have increased SMEs’ sensitivity to policy design and implementation and have raised the costs and burdens of doing business. Fragmented governance, limited institutional coordination, communication gaps, limited collaborative governance and SME engagement, rising compliance requirements, shifting market dynamics, limited resources, and skills gaps across public and private sectors increase risks to SMEs’ survival and growth, underscoring the role of MGAs in closing governance and performance gaps identified for improved developmental outcomes. Conceptually, the study shows how MGA governance design, coordination and enforcement, under central state steering, shape SME development and position SMEs as policy recipients and instruments of state reform. Empirically, it links lived implementation to outcomes within a contemporary administrative development context, offering original qualitative evidence from an embedded case study that informs governance and management scholarship. Implications reveal that policy should prioritise coordination, predictability and communication, a unified e-government system, transparent enforcement and accountability, SME engagement, a long-term set of defined policies that enable SMEs’ strategic planning, and targeted support guided by outcome-oriented indicators. SMEs should embed compliance readiness, manage costs and regulatory burdens, engage through formal channels, build supply-chain partnerships, strengthen digital capability, and adopt formal governance practices. For sustainable finance, promote legal and financial literacy and encourage investment in promising businesses as an alternative to starting a new venture while remaining in professional employment. Within this macro case limitation, recommended directions include policy-specific and sectoral analyses by firm size, comparative regional work, and longitudinal assessment of regulatory and performance-management effects on development outcomes.25 0Item Restricted Delivering Immersive Virtual Reality as an Intervention to Patients with Chronic Low Back Pain in The Kingdom of Saudi Arabia: A Mixed-Methods Feasibility Study(Saudi Digital Library, 2025) Alotibi, Fahad Salman; Hendrick, Paul; Moffatt, FionaBackground: Chronic low back pain (CLBP) has been recognised as a leading cause of disability in adults for three decades. Literature constantly calls for improved CLBP healthcare services. Immersive virtual reality (IVR) can encourage patients with CLBP to engage in exercise regimes and remain active, but the feasibility of IVR in the Kingdom of Saudi Arabia (KSA) among patients with CLBP is unknown. Aims: To investigate the feasibility of delivering IVR to patients with CLBP in the KSA. Method: Two studies were conducted. Part 1: an umbrella review of systematic reviews (SRs) aimed to identify, summarise, synthesise and critically appraise existing SRs regarding the effectiveness of VR in individuals with chronic MSK pain and disability, focusing on CLBP. The results of this previous review, along with patients and public involvement, informed the design of a protocol for testing the feasibility of delivering IVR to treat patients with CLBP in the Saudi context. Part 2: a sequential explanatory mixed-methods feasibility study aimed to examine predefined progression criteria of the feasibility of delivering IVR to a sample of individuals with CLBP and explore their experiences along with relevant healthcare practitioners in the Saudi context in outpatient department (OPD) settings. The feasibility study adopted a sequential explanatory mixed-methods design comprising two phases: the quantitative (Phase 1) and qualitative (Phase 2). Findings: Part 1: the overall confidence in the identified SRs ranged from low to critically low, whereas the certainty in the body of evidence ranged from moderate to very low. Although the results suggest that VR, either as an alternative form of treatment or in combination with other interventions, may provide a short-term positive impact on patient-reported outcomes for pain in patients with chronic primary MSK pain, it remains uncertain which specific VR intervention shows the most promise, as the included SRs grouped various types of VR together. However, results on patient-reported outcomes for disability and kinesiophobia were inconsistent. Adverse events included motion sickness, nausea, and vertigo. Part 2, Phase 1: the recruited patients included 31 males and two females over 12 weeks. The feasibility a priori criteria were met for recruitment, retention, dropout, completeness of questionnaire data, and treatment compliance and fidelity. No serious adverse events were experienced among patients. However, some incidences of non-serious, short-lasting, minor adverse events were reported. Part 2, Phase 2: analysis of qualitative data from interviews with eight male patients and three physiotherapists (the latter of whom comprised two males and one female) revealed four overlapping themes: sociocultural considerations, facilitators, barriers, and feasibility. Sociocultural considerations included visual (e.g., avatar outfit), auditory (e.g., music), contextual (e.g., same-gender IVR administrator), and IVR-specific factors (e.g., feeling ashamed to play like a child). From the patients’ perspectives, the study process and materials were described as feasible, and recommendations were discussed for IVR implementation. From the physiotherapists’ perspectives, recommendations for the success of IVR integration into the KSA healthcare system included using multiple devices and an efficient scheduling system. Facilitators, from the patients’ perspectives, included ‘positive IVR experience,’ and ‘IVR is motivational.’ Additionally, from patients’ and physiotherapists’ perspectives, facilitators included ‘IVR is therapeutically useful, easy to use, and tolerable.’ Barriers to delivering IVR, from the patients’ perspectives, were ‘personal challenges’ related to time and travel. Furthermore, the physiotherapists-related barrier was ‘time-consuming for physiotherapists.’ Moreover, from both patients’ and physiotherapists’ perspectives, barriers included ‘lack of knowledge’ and ‘support and infrastructure issues.’ Implications: The results indicate that IVR was feasible, acceptable, and tolerable among patients with CLBP and healthcare professionals in the KSA within OPD settings. IVR can be utilised to support patients’ engagement in physiotherapy OPD settings. Further research focusing on the effectiveness is warranted in this field. Furthermore, further mixed-methods research within the context of this study and other MSK conditions is warranted in the Saudi Context to reveal more sociocultural considerations.12 0Item Restricted Barriers and Facilitators to Uptake of Cardiac Rehabilitation Following Percutaneous Coronary Intervention in Saudi Arabia(Saudi Digital Library, 2025-06-17) Almoghairi, Ahmed Mohammed A; Duff, Jed; O'Brien, JaneBackground Cardiovascular disease remains the foremost cause of mortality and a major contributor to morbidity globally, with coronary heart disease being particularly prevalent across populations. In the Kingdom of Saudi Arabia, cardiovascular disease accounts for approximately 45% of all deaths, with coronary diseases as the leading cause. Treatment for coronary diseases typically involves lifestyle modifications and medications to manage symptoms. However, when these are insufficient, percutaneous coronary intervention is employed to restore blood flow to the heart muscle. Even with these interventions, patients who do not alter their lifestyle post procedure remain at high risk for recurrent cardiac events and rehospitalisation imposing tremendous burdens on health systems. Thus, effective post-discharge care is crucial, particularly through cardiac rehabilitation programs. Despite their proven benefits and cost-effectiveness, these programs are globally underutilised due to multiple barriers at the patient, clinician, and healthcare system levels. In the Kingdom of Saudi Arabia, the paucity of research further limits understanding of adherence to secondary prevention measures and barriers to the uptake of cardiac rehabilitation among patients with coronary heart disease. This backdrop sets the stage for this study to explore the country’s understudied areas of cardiology care. Aim This research project aims to identify the difficulties and opportunities in providing cardiac rehabilitation services to patients with coronary heart disease following percutaneous coronary intervention in cardiac centres across Saudi Arabia. Methods This PhD thesis employed a multiphase methodological approach beginning with conducting a systematic scoping review using the Joanna Briggs Institute methodology to identify effective interventions to promote uptake of cardiac rehabilitation (objective 1). This review systematically searched seven online databases for English-language articles published in the last decade, extending until October 2024. Reviewers independently assessed eligibility, and data extraction followed the Template for Intervention Description and Replication and PRISMA guidelines. The subsequent phase utilised a cross-sectional survey employing computer-assisted telephone interviews to collect insights from Saudi patients with coronary disease who underwent revascularisation at the Prince Sultan Cardiac Center in Riyadh and were clinically eligible for cardiac rehabilitation (objective 2). The study collected data from patients one-month post-procedure and aimed to evaluate their adherence to secondary prevention behaviours and identify their challenges when enrolling in cardiac rehabilitation programs. The further phase involved an observational cross-sectional study that distributed an online survey to cardiologists and cardiology fellows across Saudi Arabia (objective 3). This questionnaire was disseminated during the Saudi Heart Association's annual conference in October 2023 and extended through various social media platforms. It assessed participants' self-reported knowledge, attitudes, and practices regarding cardiac rehabilitation and determined impediments to their referral practice. Participants were required to have a minimum of six months of clinical experience managing patients with coronary disease post-percutaneous coronary intervention. The final phase involved a qualitative study using an interpretive descriptive approach, featuring recorded semi-structured interviews with key decision-makers in cardiology care within Saudi Arabia (objective 4). It aimed to identify the health system level challenges and potential enablers for the uptake of cardiac rehabilitation in the country. The analysis of these interviews was structured around the updated Consolidated Framework for Implementation Research, which guided the identification of themes. Results The scoping review highlighted that home-based cardiac rehabilitation internationally led to higher patient engagement and adherence to secondary prevention post interventions and effectively overcame several challenges at patient and health system levels. The observational study in phase two included 104 post-procedures Saudi patients with coronary diseases and showed a concerning prevalence of cardiac risk factors and significantly low adherence to secondary prevention measures, with only 10.6% being referred to cardiac rehabilitation. The most-cited barriers to enrolment in cardiac rehabilitation by included patients were inadequate program endorsement by cardiologists, absence of communication with cardiac rehabilitation care providers, and geographic distance to the service site. The subsequent survey involving 106 cardiologists revealed that, while they were knowledgeable about cardiac rehabilitation services and their benefits for patients following interventions, there was notable uncertainty regarding the quality of local services. This ambiguity, combined with unclear patient pathways and the limited availability of programs in practice areas, contributed to the reluctance of cardiac specialists to recommend these programs to their eligible patients. The last research examination interviewed nine policymakers and revealed systemic issues such as insufficient facilities, lack of cardiologists’ knowledge about cardiac rehabilitation, and shortage of qualified staff. This thesis recommends strategic improvements for consideration by the national healthcare system in Saudi Arabia to facilitate broader and successful implementation of cardiac rehabilitation programs. These reforms incorporate revising patient discharge protocols, enhancing the education and training of clinicians on cardiac rehabilitation, implementing effective referral systems, and ensuring equitable expansion of services across all regions. It also advocates for the adoption of innovative models of cardiac rehabilitation such as home-based and telerehabilitation programs, the development of supportive cardiac rehabilitation policies and regulations, and the engagement of higher authorities to drive these transformative changes. Conclusion This PhD thesis thoroughly examines effective interventions for cardiac rehabilitation delivery and identifies home-based models as effective alternatives to the underutilised traditional programs. It reveals critical findings pinpointing low adherence to secondary prevention measures and enrolment in cardiac rehabilitation programs among Saudi patients with coronary heart disease following percutaneous coronary intervention, primarily due to inadequate healthcare professional support and limited program accessibility. It indicates a significant knowledge practice gap in cardiologists within Saudi Arabia which affected the nationwide endorsement of cardiac rehabilitation. It uncovered systemic challenges necessitating urgent national reforms to boost program capacity, enhance healthcare professionals’ understanding of cardiac rehabilitation, and attract qualified personnel to the services. The integrated insights from the conducted studies significantly improve the understanding of cardiac rehabilitation utilisation within Saudi Arabia and similar contexts, laying a foundation for ongoing research to design, refine, test and implement innovative cardiac rehabilitation models, and encourage more international collaborative efforts for comparative studies of these innovative models.38 0Item Restricted Investigating Organisational Success Determinants for Adoption of Innovation in Saudi Deep Technology and Environmental Engineering Businesses(Saudi Digital Library, 2024-02-01) Badereg, Ahmad Talal; El-Hamalawi, Ashraf; Fotwe, Francis EdumPerformance within organisations aims to create a structure to boost working conditions and employees’ attitudes. Innovation performance is the process that encompasses the generation of ideas and strategies, as well as presentation and development and developing innovation from a resource-based perspective. Companies should invest significantly to sustain and enhance capabilities for innovation. Goals of innovation include increased market profile, high quality, and increased revenue, profitability, discovering new horizons, attracting more investment, motivating and stimulating employees and maintaining a competitive edge in the complex marketplace. The aim of this research is to critically investigate innovation enterprise mechanisms and success determinants for Saudi deep technology environmental engineering businesses, in order to develop a validated framework for innovation enhancement practices in the Kingdom. This research was carried out through an empirical study designed for the purpose. Wallach’s 3-Dimensional model and the Organisational Culture Index (OCI) were used for survey questionnaires in order to identify the Kingdom’s cultural profile (e.g. bureaucratic, innovative, supportive) and validating the developed conceptual framework. Semi-structured interviews were conducted to seek information and knowledge through describing the central theme. Case studies included deep technology environmental engineering businesses and government-based companies in the Kingdom. Initial results were promising and paving the way for innovation; however, most of the companies were facing enormous challenges, as use/implementation of innovation practices were ranked low amongst deep technology environmental engineering businesses in Saudi Arabia. Although, most of the variables were identified in the conceptual framework, it has noted that the current culture was not rather innovative or supportive but bureaucratic. Most significant challenges were lack of leadership, shortages of skills, managerial capacity and capability, lack of appropriate KPIs (Key Performance Indicators) and readiness of organisation in the Kingdom. The Conceptual framework was validated via different iterations using empirical data. The result of this work is the first empirical study in the Kingdom which has made an attempt to investigate innovation practices among deep technology companies and proposing a validated conceptual framework for successful implementation of innovation-based culture. Finally, recommendations were provided to overcome the key challenges which were identified in this research. The recommendations include training and 5 development program for improving skills, development of leadership, reforms in Saudi Educational system and adopt appropriate KPIs for innovation.7 0
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